Monday, March 31, 2008

Meet . . . KAUA'I KITTY!


(Click on any photo to enlarge.)

Hello! I'm Kaua'i Kitty, also known as Tour Cat, because I follow tour groups.

The tour groups don't come to see ME. They come to the National Tropical Botanical Garden, where I live, to see other things.

Humans are so silly. I'm the most beautiful thing here, because I'm a cat. (There's another cat here who thinks he's more beautiful than I am, but he's wrong.) But do most of the humans spend much time looking at ME?

Of course not.

They look at flowers.









And more flowers.



And still more flowers.

They look at trees.






The tops of trees.






The bottoms of trees.






Themselves standing between the roots of trees.

Poor inferior humans! They can't climb trees the way I can.

The humans also like pools and fountains.








Most of them don't seem to realize that the true purpose of the pools is to give ME lots of nice drinking water.

Sometimes I play with my friends the frogs. But these frogs don't want to play with ME. They're too busy making baby frogs.

Frogs, like humans, need to get their priorities straight.

The silliest thing that the humans do is looking at statues. Of course, this statue might be carrying cat treats. Also, anything with a fish tail is good.

But this statue can't possibly be of interest to anyone. It looks too much like a dog.

Any statue is much more interesting with ME on top of it.





I follow the tour groups to try to show them where the real beauty is: in ME. When they recognize my beauty and pay homage by patting ME, I know I've succeeded.

Then I reward them by posing on top of statues, so they'll have something really interesting to look at.



I also reward humans who pat ME by lying next to them, one of the greatest honors a human can receive.

And when especially discerning humans have paid an exceptional amount of attention to ME -- often because they miss their cats back home -- I pay them the greatest honor.

I let them pick me up. And I purrrrrrrrr.

Of course, their cats back home are far inferior to ME. But the humans have to make do with what they have.

In every tour group, there are a few discerning humans. I'm very sad when they leave.

But there are always other humans who come to visit.



So if you come to Kaua'i, be sure to visit the National Tropical Botanical Garden.

I'll be waiting for you.

Sunday, March 30, 2008

Oooops


And the mishaps continue! We got in late last night, after a blessedly uneventful trip. After unpacking and cuddling with the cats a bit, I got to bed at 1:00 a.m. Gary and I were both very grateful that we'd be able to sleep in this morning.

At 9:00 a.m., the phone rang. It was one of our priests from church. "Susan, has there been a mistake? You're on the schedule to preach this morning."

Oy! I didn't have it written in my calendar, but when I checked, it was on my printed preaching schedule. I must have offered to preach today before I knew we were going to Hawai'i, and then forgot to reschedule when our plans changed. Luckily, I had an old Thomas homily I could dust off and give again, and it's one that's exceedingly close to my heart, so that worked out.

People at church were very kind. The priest said they had a discussion instead of a homily at the 8:00 service, and my 10:30 gig went fine, although I was more than a little groggy. People who'd heard the homily before told me it was worth hearing again -- one woman even asked for my printed copy to send to her son -- and people who hadn't heard it before said very nice things about it. And everyone thanked me for preaching under emergency conditions, even though the emergency was my fault! When I told the priest about my run of klutziness and mistakes on Kaua'i, she said, "Well, you can give yourself credit for doing a good deed this morning."

I love my parish. Oh, and that reminds me: Happy belated Easter, everybody!

Friday, March 28, 2008

Kaua'i for Klutzes


Today we had a lovely visit to a botanical garden with an adorable cat. I got lots of good photos, which I'll post once we're home (probably Sunday or Monday).

We also went to Poipu Beach, supposedly "the best beach in America," which is also supposed to have even better snorkeling than Lydgate Park.

We didn't plan very well. We'd meant to rent snorkel equipment the minute we got here, but we never got around to it -- so instead of going to a big, well-stocked place like Snorkel Bob's, we wound up at a rental place right at the beach that caters mostly to surfers. They didn't have optical masks, which meant that snorkeling was right out for Gary. I decided that instead of full snorkel gear, I'd just get fins to go along with my optical swim goggles.

So I did that, and then I asked a bored lifeguard where the best snorkeling was. He pointed to a rocky, shallow area and said, "That's the safest. You can snorkel down the beach, too, but there's more current."

I opted for safety, although I was dubious about all those rocks. With good reason, it turned out: the water was so shallow that sometimes it was hard to avoid scraping my stomach on the rocks and coral, even though I was floating on the surface. (I also did quite the Charlie Chaplin routine trying to get into the water with my fins; I'm sure onlookers were giggling.) I did see pretty fish, but not nearly as many as at Lydgate. And when I was coming back in, the water knocked me down several times -- try balancing on slippery rocks in fins! -- and I hit my back on a rock fairly hard and got scraped over some coral.

I finally hauled myself back in. Gary told me I had a bleeding cut on my thigh (I couldn't see it), and proceeded to dress it with first-aid cream and a bandaid. My back was bruised, but the skin wasn't broken. I went up to the lifeguard again and asked if there was anything special I needed to worry about with coral scrapes. He yawned, peered at my thigh, and said, "No, you're fine. You need to worry if a piece is embedded in there."

If we come back to Kaua'i (which we might in two years), I'm definitely sticking to Lydgate Park. When I returned the fins, even the rental guy agreed that conditions are better there.

But there was one very cool thing at Poipu: a big seal sleeping on the beach. It had been roped off so people wouldn't go near it. Very sleek looking animal!

And now I have to pack, since we need to be out of here very early tomorrow. I'll probably be out of radio contact until Sunday morning. Be well, everyone.

I Was Wrong: Kaua'i Rocks!


I've now changed my mind and like Kaua'i better than Maui, because today I went swimming at Lydgate Park, which has a protected ocean pool for swimming and beginning snorkelers. I didn't have snorkel gear with me, but I did have my vision-corrected swim goggles, which worked fine; I just came up when I needed to breathe.

There were lots of fish! I was in the middle of a school of them at one point. Several different kinds, too: blue-and-yellow striped fish, and black fish, and silvery fish, and a larger blue-and-silvery one. They were beautiful, and I loved swimming with them.

This is why I came to Hawai'i.

Tomorrow we're going to try snorkeling in earnest at another park, but being able to walk into the water right off the beach and see beautiful fish sold me on the island.

Also, we took a nice hike today, and did some excellent shopping, and ate a very fine Italian dinner. So I'm very happy.

The only downside is that I woke up with a nasty rash on my left calf. I don't know if it's from a bugbite or from sun, but it's red and itchy and ugly. First aid cream has stopped the itching, though, and I'm keeping a careful eye on it to make sure it doesn't get bigger or suddenly start sprouting streaks.

Tomorrow we have a reservation to tour some botanical gardens, and we have to leave insanely early, so I'd better get to bed!

Wednesday, March 26, 2008

Lots of Pictures from Kaua'i


So we got here Saturday night, finally. This is the view from our balcony (which one is required by law to call a "lanai" in Hawai'i). As you can see, it's spectacular. We've been enjoying looking for whales every morning while we eat breakfast. (As always, click on any of the thumbnails to enlarge.)

We're woken at dawn each day by wild roosters, of which Kaua'i has a large population. Actually, the roosters crow anytime they feel like it. I like them a lot better than alarm clocks, and they sure are pretty.

There are also lots of hens and baby chicks. THe babies are absolutely adorable: I got a bunch of photos of them, but this is my favorite. Family groups were everywhere in this particular state park. I took one sequence of photos which works beautifully as stop-motion photography: if you look at the shots in quick succession, you can see the chicks scattering away from Mama.

We've also seen some nice cats, but I didn't get any photos of them.

Gary and our friend Jim Meadors did a grueling hike to a big waterfall: here's the pictorial proof that they made it.

I haven't attempted anything grueling, but I've done some short hikes and walks. My favorite walk is a paved bike path that runs along the water for miles. We walked there last night and saw whales playing, slapping their fins on the water.

Here's the view from that path, at dusk. The seascapes here are just gorgeous. Unfortunately, there are lots of places where the water conditions are too dangerous for swimming, so I've only been in the ocean once. (Jim's braver, but I don't want to take any chances!) Luckily, the resort has a nice pool. It's small, but at least it's rectangular, so I can do laps.

Here's the classic Kaua'i beauty shot: Waimea Canyon, "the Grand Canyon of the Pacific." We're told that the best way to see this is by helicopter, but we decided not to shell out $250 each for a one-hour helicopter ride. Only about 6% of Kaua'i is accessible by car, which means that the prices for tours via other vehicles -- boat, plane, copter -- are astronomical. The island's also small and crammed with tourists, which means that if you do want to shell out big bucks to see something, you need reservations. All of this military-style planning and expenditure isn't how Gary and I prefer to approach a vacation! The island's undeniably gorgeous, though.

And yet more gorgeous scenery: a tiny bit of the Na Pali coastline, usually visible only by boat. (And that tour costs a fortune, too.) We caught this snippet from the Waimea area. I think this is prettier than Waimea Canyon, but then, I have a thing for cliffs that plunge into surf.

If you'd prefer something on a more intimate scale, here are some rainforest ferns I photographed during a short hike through the woods.

And here are some pretty flowers. These little white flowers are all over the place.

Also these orange flowers. Also incredibly vivid red and purple flowers I didn't photograph.

And, finally, here's a shot Katharine took of Gary and me. He came out better than I did, but that's almost always true.

I'm enjoying the vacation, but I also find this island less user-friendly than Maui was. Also, I'm in one of those states where I keep doing things wrong: losing things, forgetting things, mishearing things, and generally being a dunce. If this has to happen, I'm just glad it's happening here, and not at work. I hope I get it out of my system by the time we get back home.

There's also wireless access here, obviously (although I had to pay for it). I'll post more as I'm able. Aloha, everybody!

Grand Rounds


This week's edition is up, and I'm delighted to be included.

Happy reading!

Saturday, March 22, 2008

A Simple Test


I was very interested last week to read this article about the discovery of a biomarker for depression. The discovery means that fairly soon, it may be possible to diagnose depression with a simple blood test, and also to determine if a given antidepressant was working. Many antidepressants take weeks to make people feel better, but the blood test would let doctors know long before that if the medicine was going to make the patient feel better.

As a depression patient, I'm delighted by this news. It will make diagnosis and treatment simpler and faster, and it should also quiet the nay-sayers who insist that depression is a character flaw rather than a physical illness. If this test had been available when I was first given a depression diagnosis, I wouldn't have had to listen to a dear friend say briskly, "You're not depressed. You're just lazy."

But then I thought further. I believe my current meds are working, which means that if I took the test today, the results would presumably be normal. I'd have to go off meds to find out if I really have depression. And what if those results were normal then, too? What if Science-With-a-Capital-S informed me that I don't actually have a physical illness, that I really am just lazy, malingering, or suffering from wrongthink?

Many people will rejoice at the advent of this test, but I wonder if anyone else is a little nervous about it.

Detour to Ontario


Ontario, California, that is.

The flight to Orange County was fine. But when we took off for Honolulu, the plane developed a mechanical problem with an air valve and had to turn around and land in Ontario. We're now waiting to fi nd out if they can fix the problem, but we'll probably be here for hours.

Sigh. Sometime this week, I hope to get to Kaua'i!

And We're Off!


I survived the Dreaded Week (I got a lot done, too), and in forty minutes, we're heading to the airport. The house is a mess -- my portions of it, anyway -- but I hope our catsitter will forgive us. The cats certainly don't mind.

Supposedly our resort has wifi, but that's been true other years and it hasn't worked too well. So I don't know how much internet access I'll have. I'll post if I can and if I feel like it: I may just dissolve into a large pile of goo when we get there.

We're both bringing Too Much Stuff. Someday I'll learn to pack lightly, but this isn't that day.

The Dreaded Week actually, knock wood, went better than it often has, with the glaring exceptions that both Mom and my cousin are back in the hospital. Yesterday was a bit of a challenge, since I had two large last-minute work things to do, and then I found out Mom was in the hospital, and then there was a mini-crisis (now resolved) at work. Good Friday services were, well, Good-Friday-ish. Friend #2 and I smiled and waved at each other and had no other contact. One of our parishioners, in his anthem meditation, talked about the cosmic-injustice patient who died at the hospital (whom, it turned out, he knew, and who helped him once when he was feeling down). That threw me, I have to say. When I told Gary about it later, he said, "Oh, man. You can't get away from it!" But it's just a reminder that in many ways, this is still a small town.

Okay, must turn the computer back over to Gary. Have a wonderful Easter, everyone, and a great week. If you don't hear from me, I'll make a full report when I get back.

Friday, March 21, 2008

Another Hospital Stay


My mother's back in the hospital as if this morning. She asked my sister to call 911 because she was having trouble breathing. It looks from x-rays as if this is caused by the pneumonia, which never cleared up completely.

I've spoken to her and she sounds fairly strong and cheerful, although she hates having to be in the hospital, especially over Easter. Easter isn't a religious holiday for her, but it is a time to have a nice meal with family, and my mother detests hospital food. Not that anyone likes it, but I think she loathes it more than most people do.

Everyone agrees that I should still go to Hawai'i. Thank goodness for cell phones, which make it easy to stay in touch.

All prayers will be appreciated. Thanks!

Thursday, March 20, 2008

A Matter of Life and Death


Here's my Maundy Thursday homily. I've wanted to preach this one for a long time. And yes -- because Gary asked, and some of you might too -- all those things at the hospital have really happened.

Here's the Gospel.

*

Every Maundy Thursday, we gather to remember the Last Supper, Jesus’ final meal before the crucifixion. Knowing he is about to die, he gives his friends one last commandment: “Just as I have loved you, you also should love one another.” He has already shown them what he means by washing their feet. Clad in sandals and caked in dust from a long day of walking, the disciples’ feet were probably pretty unappetizing. Washing them was a servant’s job, and the fact that Jesus did it himself vividly illustrated how serious he was about his own servanthood.

“Just as I have loved you, you should also love one another.” We usually interpret this to mean that we, too, must be servants, must do whatever we can to heal, clean and refresh God’s dusty, footsore children. But there’s another side to the task Jesus has given his followers, the one we see when Peter tells Jesus, “You will never wash my feet.”

We don’t know why Peter tried to refuse. He might have been shocked at seeing the Messiah performing such a lowly task. Or he might have been embarrassed, afraid to offend Jesus with his own corns and bunions, the blisters where his sandal straps had rubbed too tightly, the dirt underneath his toenails. Perhaps he was afraid that his feet smelled after a long hot day. “My feet are disgusting,” he might have thought. “I can’t let Jesus wash them! An anonymous servant is one thing, but I can’t show this ugly part of myself to my Lord!”

Jesus isn’t having any of this. “Unless I wash you,” he tells Peter bluntly, “you have no share with me.” A little later, he tells the disciples, “if I . . . have washed your feet, you also ought to wash one another’s feet.” He doesn’t say, “You ought to wash the feet of strangers.” He intends them to serve each other. That means that they have to let their friends, and their God, wash their feet, do their laundry, help them in need. This isn’t optional. It’s required.

Jesus is the Way, the Truth, and the Life. For his followers, there is no life apart from him. If he insists on washing our feet, that means that letting him serve us -- letting him see our corns and blisters and funky toenails -- is quite literally a matter of life and death.

Does that sound like an exaggeration? Let me tell you a modern-day story. Sometime last year, during one of my shifts as a volunteer hospital chaplain, I met a patient who’d been brought to the ER because he was suicidal. I talked to him for a long time. He was intelligent, thoughtful, and well-spoken. He’d spent a lifetime helping other people as a physical therapist, and he’d cared for his parents and his wife when they were dying. He’d emptied bedpans, changed sheets, bathed and fed those he loved. He’d been a faithful, tender servant. And now that he had become physically disabled by age and illness, he was emphatic about wanting to die. “I don’t want my kids to have to take care of me,” he said. “I don’t want to be a burden.”

“Did you feel burdened when you were taking care of your parents or your wife?” I asked him. “Or your patients?”

“No,” he said. “Of course not! I was happy to take care of them.”

“Then don’t you think other people would be happy to take care of you?”

He couldn’t, or wouldn’t, answer that question. Maybe he had felt burdened by being a caretaker, and couldn’t admit it. Maybe he didn’t have a good relationship with his children. Maybe he was embarrassed by the thought of them having to empty his bedpan. Whatever the reason, he wasn’t about to change his mind. He was determined to die so he wouldn’t have to accept help, so no one would have to serve him.

This isn’t an isolated case. I’ve met other patients, both male and female, with the same profile. They’ve spent their lives caring for other people, but they’d literally rather die than allow anyone else to take care of them. They see the contradiction, but it doesn’t change their minds.

We live in a culture that values competence, independence and autonomy. Most of us find it far easier to give help than to accept it. We fall too easily into the trap of believing that if we need help ourselves, we must be weak or contemptible. That’s especially true when we need help involving physical or emotional vulnerability. I can’t tell you how many people I’ve met at the hospital who’ve apologized for being frightened, for being in pain, for crying. Patients who are sobbing, terrified that they’ve had a stroke or heart attack, will say, “I’m sorry; I’m being weak.” Patients apologize for being smelly. I’ve met patients who apologized for bleeding.

Too many of us have been taught to consider our bodies, these awe-inspiring and miraculous gifts from God, shameful and unseemly. When our bodies refuse to obey us, we’re embarrassed. But almost all of us, as we age, will have to deal with reduced abilities.

Jesus came that we might have life, and have it more abundantly. Our lives will fall short of their full potential if we refuse to let other people help us. Accepting loving service isn’t a sign of our own weakness. It’s a sign of God’s grace.

Holy Week is about facing death, about accepting the fact that before the joyous rebirth of Easter, all of us must endure pain and incapacity. We will all, like Jesus on the cross, be vulnerable. We will all be broken. When Jesus insisted on washing Peter’s feet, he was offering a rehearsal, a training exercise. “Let me wash your feet,” he might have said. “Let me show you that your corns and blisters don’t bother me. I’m offering you the gift of learning how to accept love even when you don’t think you need it or deserve it, even when you feel ugly and unseemly and embarrassed. If you let me wash your feet now, it will be easier for you to let someone else wash other parts of your body someday, when you’re old and ill and can’t wash yourself.”

In a few minutes, we’ll have our own foot-washing, as so many other churches do tonight. Over the years I’ve been attending St. Stephen’s, I’ve noticed that only a few people participate in this part of the liturgy, even though in our case, it’s mainly symbolic. Most of us have very clean feet. I don’t know about you, but I tend to trim my toenails before Maundy Thursday, and give my feet an extra scrubbing, so I won’t be embarrassed up at the altar.

But I know that some of us simply aren’t comfortable having our feet washed. If that’s too personal for you, please come up and let someone wash your hands instead. If you can’t bring yourself to do that, then please, when you go home tonight, wash your own hands or feet. As you do so, close your eyes and imagine that Jesus is washing them for you. Instead of rushing through the task, take your time. Touch yourself tenderly, the way you believe that Jesus would. Feel God’s love in the texture of your skin, even or especially in your scars and blisters and callouses. Know that God, who sees and hears everything, knows and loves every inch of you. You are God’s beloved child, cherished beyond measure. And believe that other people can, and will, be that loving to you when you need their care.

This next year, I ask all of us to think about how we can let Christ touch us through service from other people. We might want to consider getting a monthly massage, or, once a week, asking a spouse or child to help brush our hair or smooth lotion on our skin. We might let people hug us during the Peace on Sundays. Even as we work faithfully to follow our Lord in serving the world, we might allow Christ, or another person -- or Christ in another person -- to see our pain or loneliness, and comfort us. If we can do even some of that, then just maybe, some Maundy Thursday, all of us will come forward for the foot-washing.

Amen.

Wednesday, March 19, 2008

Yarn! Yarn! Yarn!


My favorite local yarn store is having their biggest sale of the year: 50% off all yarn, books and needles. The sale started at 10:00 this morning. I got there at 9:55, and I wasn't the first person inside. By the time I left at 11:00 -- they wind skeins into balls for free, and I had a lot of skeins! -- the parking lot was more crowded than I've ever seen it.

I bought a lot of yarn, enough to handle all my Christmas knitting. I'm set for the summer. And oh, it's yummy stuff! Mostly all wool! Gorgeous solids, heathers and tweeds! Plus a 300-yarn skein of brightly hand-dyed variegated thick-and-thin wool. (Gary's comment was, "You have to wear sunglasses when you look at that stuff!")

My stash box is full, yarn interspersed with lavender sachets to keep away moths. At some point I'll invest in a cedar chest, but that would mean less money for yarn. Hmmmmm.

Anyway, it was a very decadent shopping spree, but all the yarn will get used, and most of it will become gifts. And it makes me deliriously happy. If the Spring Equinox is when we descend into the underworld, my knitting is the thread that will keep me tied safely to home.

Meanwhile, I've now taught my last classes before spring break, although I still have several significant chunks of work to finish before we leave.

But I have new yarn! Life will go on!

Tuesday, March 18, 2008

Grand Rounds, and a Postscript


This week's edition is up, and I'm honored that my Only Two Prayers post was included.

I just learned that the first code patient I talk about in that post -- the horrendous cosmic-injustice case -- died.

I don't feel like writing any more right now, except to say that my heart is with the family.

Monday, March 17, 2008

Super-Duper Glaucoma Test


I don't have glaucoma. Yay!

I do have retinal "lattices" (common in near-sighted people) that could predispose me to detached retinas. I also have something funky going on with my optic nerve -- thinning, I think -- that concerns the doc a bit; she wants to see me back in six months for a retest. I'm sure in six months it will be fine. This is just another of Susan's Strange Symptoms, the ones that vanish under intense scrutiny from doctors. Same old same old, although it's nice when the docs are thorough.

The copay for the OCT (lots of pretty flashing lights! yay!) was only $30. Double yay!

To celebrate, I went to a yarn store and got some gorgeous yarn at a great sale price: enough yarn for a scarf was only $12, and this was at the fancy yarn store in town. Yay!

Sunday, March 16, 2008

Lizard SOS


March, and especially this next week, is full of bad memories for me. I've talked about this on the blog before, and I've discussed it ad infinitum with various therapists. Last year actually went fine, although the year before didn't, so I hoped that this year I was going to sail through.

However, my psychiatrist informs me that it takes three years for body memories to go away, which means that I have to have two more years of an uneventful Spring Solstice before my lizard brain won't be screaming "Run away, run away!" every third week of March.

Two of the traumatic memories involve the implosion of important friendships; in both cases, people I loved handed me a long laundry list of all my faults and told me that a) they didn't actually like me much and b) they never wanted to speak to me again. I haven't heard from person #1 since, although person #2 and I have exchanged cautiously civil e-mail recently.

Last night, I had a dream about encountering person #1, who acted like nothing had ever happened. In the dream, I was very uneasy about this and felt like I was walking on eggshells.

This morning, I learned that I'll be seeing person #2 later this week. I might be able to duck the encounter -- which is probably what my shrink would advise -- but if I do that, I won't have the chance to replace bad memories with a better one, which is what I'm hoping will happen.

I thought I was dealing with all of this like an adult, until I went to the health club to swim and realized that I was actually a terrified little knot of anxiety. There's nothing rational about this: it's lizard-brain PTSD stuff ("Run away! Run away!"). My Inner Lizard is convinced that somebody in the world is out to get it this week, and all it wants to do is hide under a rock to keep itself safe. It doesn't even like my writing this post, because it's scared someone will use the info as ammunition. The Lizard's motto is, "If you show your soft white underbelly, someone will consider it an invitation to stab you."

This isn't a week when I can hide under a rock, though, and I'm choosing to trust my readers and ask for help (which is the theme of the homily I wrote last night, so I'm trying to practice what I preach!).

Whatever your method is of sending positive, loving energy to people, please send me some until Saturday. And if you know of any techniques to reassure frightened, suspicious lizards, please send those, too!

More Fun With Downloads


I've been having fun exploring nature sounds, which I find a soothing accompaniment to work. Right now I'm listening to crashing waves. I can almost feel the sun and smell the salt air, an especially pleasant experience because it's snowing here at the moment (I hope we do our Palm Sunday procession inside!).

Last night, I searched for MP3s of purring cats. Yes, they exist! I decided not to pay for a download when I can listen to my own cats purr, but it's comforting to know that I'll still have access to the sound if I'm ever catless.

Meanwhile, one of the MP3 tracks was this hilarious clip of kittens meeping for food while their mother purrs. You can listen to a snippet of it by clicking on the little arrow to the left of the MP3 title. I played it last night, and instantly the entire household was on alert. Gary said, "Oh my God, have we gotten more?" just as all three cats came racing into my study to confront the intruders.

We are a simple people, easily amused.

Saturday, March 15, 2008

Bits o' Progress. Plus Shopping.


Today I graded scads of papers and wrote my Maundy Thursday homily (which has now been vetted by Gary and one of our parish priests; since the bishop will be there, I wanted extra feedback).

My brain hurts.

Tomorrow I have to grade a slightly smaller scad of papers, finish prepping one of my classes for Monday, and chip away at three work reports that are due on Friday.

Normally I could do some of this on Monday morning, but not this week, since I'll be having the super-duper glaucoma test. Ick.

Have I mentioned that my brain hurts?

In the meantime, I've discovered the quick high to be obtained by downloading MP3s on Amazon. Don't ask me why I didn't know about this before. Gary told me about it tonight, and now I'm hooked. MP3 downloads are definitely the musical version of crack. We'll probably have to take out a second mortgage on our house because of my song downloads, although I did figure out that I don't have to download everything I might want this very second. It will all be there waiting for me whenever I want it.

All day. All the time. 24/7.

Are there 12 Step groups for MP3 junkies?

I will get through this week I will get through this week I will get through this week. I think I can I think I can.

And tomorrow's Palm Sunday. Happy Holy Week, everybody!

Top o' the World


Figaro is our most intrepid and athletic cat, able to leap to the top of tall bookcases in a single bound. He also likes balancing on any high, narrow surface, and particularly enjoys walking across the top of doors.

Last night he scaled the peg-rack in the bedroom -- a simple task, because there are lots of sweaters and bathrobes for him to cling to on the way up -- and then pondered the problem of transferring himself to the bedroom door. He's done that plenty of times before, but this time the task defeated him, maybe because Gary had hung a pair of slacks to dry over the door, and Figgy wasn't sure he'd have sufficiently stable footing. Mewing piteously, he spent a few minutes pacing back and forth on the peg-rack, occasionally extending a paw towards the top of the door, before he thought better of the whole enterprise and scampered back down again, scattering sweaters and bathrobes on the rug.

This is one of those times when we wish we had a video camera. Figgy's Mountaineering Adventure would have made a great YouTube.

As always, click on the thumbnail above to enlarge.

Friday, March 14, 2008

That Time of Year


When I looked back over previous blog entries, I realized that my hissy fit about this week's shift closely mirrors another gnarly situation at the hospital, almost exactly a year ago.

This time around, I think I did a better job controlling my outward demeanor, so I guess I've made progress.

Both shifts were the last before a vacation, and my fatigue was clearly showing. At the end of my shift this week (which ran overtime because of the code), I said goodbye to a few ED folks and mentioned that I wouldn't be back for three weeks.

"Oh," said one of the nurses, "where are you going?"

"Hawai'i!" I said. "Don't you all hate me right now?" They laughed. (Actually, next week I'll still be here, but I have too much to do at work and church to get to the hospital. The following week, though, I'll be in Kaua'i.)

Another nurse sniffed, rolled his eyes, and said, "Oh, I thought you were going to do mission work in Iraq or something."

Nope. I'm going to lie on the beach and be a vegetable. But first, I have to get through this next week.

Thursday, March 13, 2008

Only Two Prayers


My hospital shift this week began very uneventfully. There were a lot of patients, but everyone seemed fairly cheery. I got lots of requests for water and blankets, but none for prayer.

Three hours into the four-hour shift, I still hadn't been asked for prayer (athough the water and blankets had been flowing at a merry pace). I was starting to think that I was about to have my first shift, in the three-plus years I've been doing this, with no prayer requests at all.

Then, forty-five minutes before I was due to go home, there was a code in another part of the hospital.

I went to the code, as all chaplains are supposed to do, and found two staff chaplains already there. They stayed in the immediate area to be with the patient and several relatives. I went to a waiting room to comfort another relative.

I can't go into specific details about the case, both because of HIPAA and because this situation would be hard to disguise or fictionalize. I can't think of any fictional version that would come close to the awfulness of the actual scenario.

So do this: imagine the most contrived, tear-jerking, improbable medical Movie of the Week you've ever seen. Now up the improbability, tear-jerking and cosmic-injustice levels by a factor of, oh, ten thousand. That's what this case was like. This was one of those cases you'd never believe if it were fiction, one of those cases that would make you roll your eyes, throw the book across the room, and groan, "Oh, come on!" to the absent author.

Remember the scene in GalaxyQuest when Gwen and Jason are running through the chompers, and Gwen (played brilliantly by Sigourney Weaver) sputters at Jason, "I hate this episode! This is a badly written episode!" This was like that, only not funny. Not at all. Not even a little bit.

Sometimes I think God's a really bad writer, because so many of the things we label divine intervention would seem simply ludicrous if someone put them in a story. And when the plot's tragedy and not comedy -- even though Christians cling to their faith in Easter through the worst Good Fridays the world can throw at them -- well, then the stories don't just make us roll our eyes. Then they make us furious.

Sitting with the sobbing relative, I was furious, ranting (silently) at God, "What are you thinking? Come on! Surely you can do better than this!"

The relative, on the other hand -- the entire family, it turned out -- had rock-solid faith. "I've been telling myself two things through all of this: God loves us, and God has a plan, even if we can't see it." And I nodded and made encouraging noises and tried to look pastoral, while inside I was thinking, This is a plan? My cats could come up with a better plan! And if this is your idea of love, I'd hate to see the alternatives!

Deep down, I know better. Honest. I've seen coherent plots spring from bewildering chaos, in life as in fiction. I always remind grieving families (if they're Christian, as this one was) that we don't worship a God who promises to remove all suffering: we worship one who promises to be with us during it. We worship a God who watched his own Son suffer and die, who understands that agony. And we worship a God who promises that new life will arise from tombs.

I said all that to the relative. I said the right things, but I sure wasn't thinking them.

A minister I know likes to remind people that raging at God is a form of prayer. I pass that along to patients all the time. This time, I needed to remember it myself.

And yes, the relative asked for prayer, the first of the shift. I think I managed to do a credible job.

Meanwhile, the medical staff was amazing. A nurse came out to give us regular updates, and was absolutely awesome with the relative: she did a far better job on the pastoral side than I did. And eventually, the patient stabilized just enough -- still in dire shape, but alive against all expectation -- that I felt able to leave. In the meantime, the family had fervently thanked everyone in the vicinity. It was obvious from listening to them and watching them that they have a robust support system: not only are they people of strong faith, but they're close to their doctor (who's also a person of strong faith), and they have lots of family and friends in the area.

Waiting for the elevator to go back downstairs, I saw someone else crying. I introduced myself and asked if I could help. This person, it turned out, also had a relative in bad shape in the hospital (although in less serious condition than the code patient). This person also asked for prayer. But the second scenario included none of the support systems of the first: in this case, there were no other family, no friends, no faith community, no strong connections with caregivers. I do know that the relative had been referred to social services, so that's a step in the right direction. But although the second patient seemed to be in less critical shape than the first, I suspect that the second family will have a harder time coping, because there are so many fewer people to help.

I only offered two prayers at the hospital this week. I wish I hadn't had to offer either of them.

In her book Traveling Mercies, Anne Lamott observes that there are really only two prayers that any of us ever offer: "Help me!" and "Thank you!" This week, I helped two people pray the first. I pray that one day -- sooner rather than later -- both of them will be able to pray the second.

Postscript here.

Tuesday, March 11, 2008

Yay, Rob!


My friend Rob Lively just sold a science-fiction story to a Canadian magazine. He wrote the story when he was in one of my fiction workshops, and I love it. It's about an android who learns to love jazz; it's just gorgeous, very haunting. (And I don't even like jazz!)

Rob and I go way back. I first met him in 2000, when he took a summer course I was teaching on science fiction. Since then, he's been in a number of my classes. He was one of my students when the Dean walked into my classroom to tell me I'd gotten tenure; Rob was the only other person in the room who knew what that meant, and immediately started clapping.

He's now an English professor himself at Truckee Meadows Community College, where he teaches a back-breaking five courses a semester. He's also working on his PhD at UNR. With all that, plus a family, I'm amazed that he has time to submit stories.

He just e-mailed me the publication news, and I'm absolutely delighted. Go, Rob!

Tree Cozies


Alert reader Sherry sent me a link to this story about some knitters in Ohio who've crafted cozies for thirty-three pear trees.

Come Christmas, they'll have to revise that ever-popular carol:

Two turtledoves
And a sweater on a pear tree!

Knitters everywhere now have yet another use for leftover yarn.

Harumphhh


This week's edition of Grand Rounds is up. I submitted my "Is Anybody Listening?" post, but it didn't get in. Pretty ironic, considering the subject!

I've gotten good comments on that post even without GR readership, though. And the other GR posts look great!

Happy reading!

Sunday, March 09, 2008

Is Anybody Listening?


A 46-year-old Dominican man visits me for the first time, having been assigned to my patient panel by his Medicaid Managed Care plan. He has been suffering from shortness of breath and chest pains, and he fears for his heart. I say to him at the start of our first visit, "I will be your doctor, and so I have to learn a great deal about your body and your health and your life. Please tell me what you think I should know about your situation." And then I do my best to not say a word, to not write in his medical chart, but to absorb all he emits about himself -- about his health concerns, his family, his work, his fears, and his hopes. I listen not only for the content of his narrative but also for its form -- its temporal course, its images, its associated subplots, its silences, where he chooses to begin in telling of himself, how he sequences symptoms with other life events. After a few minutes, the patient stops talking and begins to weep. I ask him why he cries. He says, "No one ever let me do this before."

-- Rita Charon, Narrative Medicine: Honoring the Stories of Illness, p. 177
Dr. Rita Charon founded the discipline of narrative medicine to teach doctors how to listen carefully to patients, and thus how to be better caregivers. Her work strongly supports the contention -- one borne out repeatedly in my work as a volunteer ED chaplain -- that close attention to patient stories is itself a clinical intervention, a powerful way to promote healing. We know that patients do better when they have a support system, when they know that people care about them as particular individuals. It makes sense for physicians and other providers to be part of this network if possible.

And yet the current healthcare system in the U.S. seems to be working against this kind of care.

Last month, I gave a presentation on narrative medicine to third-year medical students. One of them told me that she'd planned to go into psychiatry precisely because she wanted to listen to patients; she'd recently decided against the specialty, though, after learning that psychiatry is increasingly a matter of medication management. Listening is the realm of psychologists, not physicians.

The next day, I gave another presentation -- this one on the related subject of woundology -- to family-practice residents. I tried to encourage them to listen to patient stories, to try to figure out why a patient might be invested in clinging to certain symptoms. Their unanimous reaction was that such patients would be referred to a psychologist: "We only have fifteen minutes with each patient, and we can't bill for depression diagnoses."

During my volunteer shift later that week, I listened to an ED nurse rant about how little time managed care allows providers to spend with patients. "If you have a 77-year-old woman who's just lost her husband and has a list of symptoms as long as your arm and hasn't been to a doctor in ten years, how can you possibly do an adequate job in fifteen minutes?" And she was talking simply about the task of taking a history and making a diagnosis, not about getting to know the patient as a particular individual with her own family, fears, and hopes.

My gut impression is that listening in the American medical system has been relegated to psychologists, social workers, and chaplains (who often have little enough time themselves). But Charon's in that system; furthermore, the patient she describes is on a Medicaid Managed Care plan. She elicits the stories of all of her patients. How can she do it? How does she have the time?

A psychologist friend, when I passed along the medical student's comment about psychiatrists, said, "No, that's not true. Some of them still find time to listen to patient stories." How do these psychiatrists do it, and where are they? In the office where my psychiatrist practices, MDs do medication management: therapy is delegated to the psychologists and MSWs. My doctor's very nice and usually spends half an hour with me, rather than fifteen minutes; we have conversations. But I doubt she'd have the time to do what Charon does.

So here are my questions for my readers:

1. Do you know MDs who make a practice of deep listening? How are they able to do this within the current system?

2. How can we encourage more MDs to do the same thing?

3. If you're a patient who's been listened to -- or hasn't been listened to -- what difference do you think that made in your healing? If you're a physician who's made the time to listen, what difference do you think it's made in patient outcomes?

Thank you!

Beautiful Live Animal


Here's a nice contrast to yesterday's post.

Harley approves of Cabela's, because they provide excellent shoeboxes. He spent almost all day curled in this one.

Why do cats love to cram themselves into spaces too small for them? It's one of life's mysteries! Harley's an energetic practitioner of that particular art: one of his favorite hobbies is to crawl headfirst into a wastebasket until only his rump and tail are sticking out. Sometimes he'll knock the basket over by accident and go rolling around the floor.

Anyone who thinks cats are boring hasn't lived with them!

Saturday, March 08, 2008

Beautiful Dead Animals


Okay, Dear Readers, this is a post about disturbing stuff. Consider yourselves warned.

Let me begin by saying that I'm not ashamed to be a carnivore. ("Top o' the food chain! Top o' the food chain!") I eat meat and wear leather. I know and like people who hunt, and I have no trouble with hunting if people do it responsibly and eat what they kill. In fact, I often think that those of us who eat meat ought to be reminded where our food comes from by having to, oh, kill a chicken once a year. I've eaten and enjoyed venison, and I understand that hunting can be a very important part of culling animal populations (although those populations are often out of whack because of other ways humans have messed with the food chain, but never mind). I know that most people who hunt are sane individuals who are rigorous about gun safety. Okay?

Okay.

Today Gary and I went shopping. I needed a new pair of hiking boots for Kaua'i. Usually we go to REI or Patagonia for that stuff. REI and Patagonia are, of course, populated mainly by NPR liberals like us, who trek into the wilderness to improve their cardiovascular health and take pictures.

But last week, Gary had said, "Oh, there's a big new outdoor store that just opened. We should go there to look for your boots." So this morning, I suggested that we try out the new place.

The new place is Cabela's. It's huge. And it's full of dead animals.

When you enter the gigundo building, the first thing you see is a taxidermy exhibit of African animals, including an elephant, a lion and a leopard. That bothered me so much that I made a beeline for the shoe department, where a stuffed turkey and a stuffed wolf, among other critters, watched me shop from their wall mounts. There were more deer heads (and bodies) in this place than I could count, but I know that deer become real pests in places they overpopulate. Also bearskin rugs from formerly live bears. Those were hanging on the wall; I don't know if they were for sale.

Some of the animals bothered me more than others. I eat turkey, but who eats wolf? Much less leopard? (Excuse me: Aren't most big cats endangered? Am I missing something?) Gary told me later that he'd seen lots of stuffed fish -- okay, I can deal with that, mostly -- as well as a stuffed polar bear. Polar bears are definitely endangered. I'm sure this one was either a clever fake or had been killed before the bears became endangered (or had been killed in self-defense in some Alaskan village) but it still bothered me. The store cafe serves game meat like elk, and that bothers me less.

I found a pair of hiking boots, although the selection of women's shoes wasn't very good. I wandered around trying to find Gary, and instead found myself blinking at displays of what looked like hunting camouflage for infants. (Turns out I wasn't hallucinating. Now, class, let's discuss gender stereotypes. Look at the baby boy wearing a camo t-shirt that says, "This is what a real hunter looks like." Now look at the baby girl wearing a camo dress -- with lace and ribbon -- that says, "Cute as a button.") The store was mobbed, and there were lots of kids.

I finally found Gary, who told me that the gun and ammo selection more than made up for what the women's shoe department lacked. He also said there were lots of toy guns, and lots of kids playing with them, presumably so they'll be ready for their first .22 when they're eight and their first hunting rifle when they're twelve. (Yes, I know: most hunting families are obsessive about gun safety for kids, and good for them.) Also, the store sells blowguns: what the hey? Are these used for hunting? (Silly me! I should have checked on Google before I wrote that question. Yes, blowguns are used for hunting. Also fishing.) The store also sells archery equipment, which is really kind of cool. Gary and I agreed that anybody who can sneak up on a deer and kill it with an arrow has our utmost respect: that takes skill and also gives the critter a fighting chance, unlike hiding in a tree until the beastie shows up and then blowing it to Kingdom Come with a high-powered rifle.

The store had an archery range -- Gary told a funny story about a salesman trying to teach a ten-year-old girl not to shoot her arrow straight up in the air -- but no shooting range, thank goodness. There were laser guns people could use for target practice, though.

It all made me very queasy. I kept thinking about the leopard. I kept thinking about the couple Gary and I met about ten years ago who were in Reno for a Safari Club International convention. The woman told us brightly that one of her life goals was to kill a leopard. The man explained that the organization's very active in wildlife conservation: they don't want leopards to become extinct, because then there won't be any left to kill. (Okay, he didn't exactly phrase it that way, but that was what I heard.) Gary and I just looked at each other. Why would anyone want to kill a leopard? If it were attacking you, okay, you might have to, but why would you pay big, big bucks to fly halfway around the world to find a leopard and kill it?

I don't get it.

Killing deer for food in your own neighborhood, I get. Really, I do. But the "Fly to exotic non-Western countries! Trek through gorgeous landscape! Find beautiful animals -- and kill them!" thing just goes right over my head.

When we were leaving the store, I said, "I don't think I want to come here again."

Gary said, "This is the mainstream. Welcome to America."

I said, "I'll stay on the margins, thanks. The next time I need hiking boots, I'm going to REI or Patagonia."

As we were leaving the parking lot, we passed a group of Goth kids headed towards the store. They were dressed all in black, and one of them, a tall young man, was making rat-a-tat-tat shooting motions with his hands while the others laughed. Gary said, "Don't worry. I don't think the store sells semi-automatics or assault weapons, so if they're planning to shoot up their school, they'll have to go somewhere else."

I don't buy into stereotypes about Goths, who are consistently among my best and most personable students. I'm sure the kids were going to the store to write an article about it for their school paper or something. But it was still a disturbing image.

Meanwhile, speaking of hiking and disturbing images, the other day I took a walk on the paved paths that wind between the housing developments in our neighborhood. There are strips of wild land here, and we have coyotes in these parts, so when I see the remains of small animals, I usually figure some coyote has just had a meal. But yesterday I passed a dove or pigeon that had been shot and was lying dead on the asphalt. A little later, I passed a lump of fur that looked like the tail of some animal (I'd say fox, but I don't think we have those here). A little after that, I passed a doll lying on a rock. Sometimes people find toys and put them on rocks or walls where they'll be visible if kids are looking for them, but this doll looked odd because it seemed to be doing a pushup: it was lying face down, but with arms extended, so it was propped up on its hands.

I picked it up and turned it over. The doll's face had been burned off.

Cute as a button.

Gahhhhhhh.

I wonder if I'd be less sensitive to all this if Brianna Denison hadn't just been murdered.

I've never felt unsafe on the paths between the developments before -- for one thing, there are almost always folks walking dogs there -- but I have to admit that this time, I turned around and hightailed it for home. The walk was just starting to feel a little too much like a horror movie.

Dribs and Drabs


Yeah, I know, I've been really bad about posting, but that's because -- true to March's reputation as Hell Month -- I've been Beyond Busy. And yes, a lot of it's my own fault for procrastinating. But still.

The good news:

In two weeks, we leave for Kaua'i!

We've already booked Spring Break in Cabo for next year. Wheeee! This means that Gary and I have to get new passports, since our old ones are long, long expired. The U.S. State Department site says their turnaround time is 4-6 weeks, though, so we have time.

Questions: I've never been to Mexico. We'll be staying at a nice resort, so I'm assuming we won't have to worry about the water there -- and we'll drink bottled water elsewhere, and avoid ice and raw food like salad -- but I read a travel health site that advised people going to Mexico to get typhoid and Hepatitis A shots. Nobody I know who's gone there has done that, though (at least, not if they were going to a cosmopolitan place like Cabo). Does anyone have any tips on this either way? When I was eight, my family went to England and rural Ireland for three weeks, and we did get typhoid shots, and they made all of us sleep for something like twelve hours. I'd rather avoid that if possible.

Knitting news: My friend Alex and his wife Maia love the shawl I sent him for his birthday. I've asked him to send me a photo of him wearing it, so when I get that, I'll post it. Also, I'm almost done with my cousin Val's feather-and-fan shawl: I hope to finish it tomorrow or Monday.

What else? Oh, this week's hospital shift was busy, but spiritually fairly uneventful. We had a critical patient, but the family asked for a priest and wanted nothing to do with me (whether because I'm female or a volunteer or both, I don't know). I got more exercise than usual, though, because the hospital's being remodelled, and Fast Track is now approximately five miles from the main ED. Okay, that's an exaggeration, but I did a lot of walking! Spiffy new quarters, though.

One of the social workers from last week greeted me very warmly, and when I apologized for being so wound up about the domestic-violence case, she tut-tutted me and said I'd been fine. So that was reassuring. And I got to give cute toys to cute kids, which is always a pleasure. (One of the nurses said, "I think you have more fun than the kids do," and I said, "Well, I certainly hope so, since I'm not sick, don't have needles stuck in me, and don't have to stay in bed!" She laughed.)

And that's about all the news. I'll try to be better about posting, but I'm not promising anything!

Wednesday, March 05, 2008

Cat Naps


Harley and Figaro were sleeping in cutely contorted positions the other day, so I took some photos.

Harley and Bali both had a really exhausting day yesterday, since they had to go to the vet: Bali for a routine checkup and shots, Harley for followup bloodwork to check his kidney values, which had been slightly elevated when he had his teeth cleaned in January.

It took us twenty minutes to get Bali into the cat carrier: Gary would almost get him in, and then he'd shoot free again. In the process, I got scratched (not badly), and Bali got so stressed out that he was shaking and panting in the vet's office, and his heart rate was 240. He eventually calmed down, though, and was pronounced in excellent health.

Harley was a little calmer about the whole thing -- although his heart was galloping, too -- but his kidney values haven't changed since January. On the one hand, that means he's not getting worse, but we'd hoped that his slightly high creatinine level was just a fluke. Apparently not.

The vet gave us two choices: we can put him on a special kidney diet now -- which, in a multi-cat household, means putting all of them on the expensive prescription diet, and hoping they'll actually eat the stuff rather than turning their noses up at it -- or we can keep checking his bloodwork every six months. We opted for the second choice, especially since we have two trips coming up. Asking a cat sitter to cope with a special diet is a bit too much.

There is a possibility that Harley's creatinine levels just naturally run a little high; we're hoping that's what's going on!

Tuesday, March 04, 2008

Hurrah!


Reader Lisa suggested that I move labels to the beginning of posts as a way of providing subtle trigger warnings, and I've now done that.

Thanks, Lisa! Great suggestion!

Monday, March 03, 2008

Grand Rounds


This week's edition is up, with a theme of "new beginnings," and I'm delighted to be included.

Happy reading!

Sunday, March 02, 2008

Revision to the First Rule of Fiction


Okay, maybe you don't want to do the worst thing to your characters, because the worst thing you can do to fictional characters (much less living, breathing ones) is to deprive them of their free will, the ability to make choices. And characters who can't make choices can't make decisions, which makes them pretty poor pilots of plot.

This is also why the best characters are usually the ones who insist on going in directions that surprise their creators. Note to writers: The character's always right.

This is also why a world where no one could ever do anything wrong, or where nothing bad ever happened (requiring characters to figure out how to respond) would be really boring -- which is one tiny part of the always-complex response to the everlasting issue of theodicy.

Also, compromised choice is why addiction's such a terrible condition, and why people who roll their eyes and say "Well, why don't they just choose not to drink (or snort or spend or overeat or gamble or shoot up)!" don't know what they're talking about. If someone has full choice over whether to do something, it's not an addiction. Addicts are people who can't, on their own, reliably exercise free will in relation to their addiction, which is why so much recovery emphasizes abstinence. This varies with the substance, of course: one shouldn't entirely abstain from food. The usual formula is that addicts can choose whether or not to initiate use of the substance -- i.e, "pick up the first drink" -- but that at some point after they've done so, the substance controls them, rather than the other way around, in a way that non-addicts can't understand because their own free will in this area has never been compromised. The threshold of choice has to be moved way, way back: choice is a concept that still makes sense for the first drink, but may very well have evaporated by the fourth or fifth. And it takes time to figure that out.

Yes, I know, this is a simplistic analysis, and many holes can be picked in it. At some point, I'll write a fuller post about why the rhetoric of choice in relation to deprivation -- addiction, poverty, homelessness -- makes me so crazy. For the moment, these are some random thoughts during a break in grading papers.

Back to those papers! Hey, I can choose when to stop blogging! And I haven't knit all day, although doing so will be my reward if I get all the papers done by my deadline.

Saturday, March 01, 2008

Lucky Charms


Here's a photo -- not a very good one, alas -- of three of the eight stitch markers my sister made me. They're all different, which makes them extra fun. This will at least give you a sense of what they look like. I especially like the unusual jump rings, with their pretty pattern. (As always, click to enlarge.) I wish I'd taken this photo with the right side of the knitting up, but oh well!

Meanwhile, Gary managed to get this at-least-partly-in-focus shot of four other items. Last Sunday, I found the little ceramic cat in my church mailbox: someone who knows I love cats had left it there for me as an anonymous gift (and no one would take credit, although I have my guesses!).

Below the cat is my newly constructed good-luck necklace; since it's now March, my official Worst Month (talk about triggers!), I decided that I needed all the help I could get. The chain's from Maui, and thus conjures good memories. The celtic cross in the middle, which I found in the WisCon dealers' room last year, is the cross I wear to the hospital: it's enough like a cross to be recognizable, but it's also subtle enough not to alarm patients with histories of religious abuse. The woman who sold it to me said it was a St. Brigid's Cross, but I think it actually represents Brigantia, the celtic goddess of healing and creativity, who was co-opted by Christianity as Brigid. For me, it's the face of the divine feminine, the healing aspect of Christ. (The patients who've noticed it have really liked it; I've never gotten a negative response.)

I've been wearing the cross for months. A week or so ago, I saw a Jewish friend at the gym and admired a necklace she was wearing. She told me it was a hamsa, a protective hand; it turns out that this symbol is beloved by both Judaism and Islam. I became fascinated and decided that I wanted one for myself, so I ordered my pretty silver-and-onyx version from a fun online vendor (with excellent customer service, btw) called the Luck Factory.

I'm very fond of the number three, so I needed a third charm. I decided to use a tiny pink agate heart my mother gave me one Valentine's Day years and years ago, when I was in junior high or high school. The pink balances the darkness of the onyx, and the heart repeats the heart shape at the top of the hamsa and in the face on the cross.

So there you go. Susan's Symbology 101. If nothing else, I now have an interesting conversation piece!